Citation Nr: 21073118 Decision Date: 12/07/21 Archive Date: 12/07/21 DOCKET NO. 19-25 475 DATE: December 7, 2021 ORDER Entitlement to service connection for right lower extremity radiculopathy, claim as peripheral neuropathy is granted. Entitlement to service connection for left lower extremity radiculopathy, claimed s peripheral neuropathy is granted. REMANDED Whether new and material evidence has been received to reopen the claim for service connection for hypertension is remanded. Whether new and material evidence has been received to reopen the claim for service connection for a kidney condition is remanded. Entitlement to service connection for an acquired psychiatric disorder, to include posttraumatic stress disorder (PTSD), is remanded. Entitlement to service connection for bilateral eye condition (sensitive to light) is remanded. Entitlement to service connection for bilateral tinnitus is remanded. Entitlement to service connection for headaches is remanded. Entitlement to service connection for right hip condition is remanded. Entitlement to service connection for a left hip condition is remanded. Entitlement to service connection for right upper extremity peripheral neuropathy is remanded. Entitlement to service connection for left upper extremity peripheral neuropathy is remanded. Entitlement to service connection for skeletal arthritis, entire joint system, is remanded. Entitlement to service connection for temporomandibular joint dysfunction (TMJ) is remanded. Entitlement to service connection for erectile dysfunction is remanded. Entitlement to an increased rating in excess of 10 percent for status post right knee injury/patellofemoral pain syndrome with degenerative joint disease is remanded Entitlement to an increased rating in excess of 10 percent for instability and subluxation, right knee as secondary to the service-connected disability of status post right knee injury/patellofemoral pain syndrome with degenerative joint disease is remanded. FINDING OF FACT The probative medical evidence of record shows that the Veteran has bilateral lower extremity radiculopathy that is the direct result of his service-connected low back disability. CONCLUSION OF LAW With the resolution of reasonable doubt in favor of the Veteran, the criteria for establishing service connection for left and right lower extremity radiculopathy, claimed as bilateral peripheral neuropathy of the lower extremities are met. 38 U.S.C. §§ 1110, 1131, 5103, 5103(a), 5107 (2012); 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.304, 3.310. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from March 1970 to April 1991. This matter comes to the Board of Veterans' Appeals (Board) on appeal from a rating decision of Department of Veterans Affairs (VA) Regional Office (RO). The issue of entitlement to increased evaluations for the Veteran's right knee was previously before the Board in December 2018 and remanded for additional development. That issue has since returned to the Board. The Veteran was provided with a hearing before the undersigned Veterans Law Judge (VLJ) in June 2021. Under the laws administered by VA, service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active service. See 38 U.S.C. §§ 1110, 1131 (2012); 38 C.F.R. § 3.303 (a). Service connection may also be granted for any disease diagnosed after discharge from service when all the evidence, including that pertinent to service, establishes that the disease was incurred during service. 38 C.F.R. § 3.303 (d). Generally, the evidence must show: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service. 38 C.F.R. § 3.303 (a); Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004). Additionally, service connection may be established on a secondary basis for a disability which is proximately due to or the result of service-connected disease or injury. 38 C.F.R. § 3.310 (a). The Veteran contends that he currently suffers from bilateral nerve disability of the lower extremities that are the result of military service. At his June 2021 Board hearing, the Veteran indicated that such pain appeared to originate from his back injury. A review of the Veteran's service treatment records does not reveal any complaints or treatment for peripheral neuropathy, or other lower extremity nerve impairment. August 2017 and March 2018 VA examinations did not find evidence of radiculopathy, but treatment records from a private pain center in May 2018 show that the Veteran first began to complain of radicular bilateral leg pain in relation to his back disability. Bilateral lower extremity radiculopathy that was associated with service-connected back disability was diagnosed via myelogram in January 2020. An April 2021 VA examiner confirmed the presence of sciatica, radiculopathy, of the right lower extremity related to the service-connected back disability. On this record, the Board finds that with the resolution of reasonable doubt in the Veteran's favor, it may be concluded that bilateral lower extremity radiculopathy was caused by the service-connected back disability. The Veteran has been shown to have current diagnoses as well as a service-connected back disability upon which to base secondary service connection. Further, the medical evidence of record noted above, appears to show a nexus between the two. Resolving any reasonable doubt on the question of a nexus between service connected disability and the claimed disability in favor of the Veteran, a basis upon which to establish service connection for bilateral lower extremity radiculopathy has been presented. REASONS FOR REMAND 1. All Remaining Issues The Board notes that the Veteran testified at the June 2021 Board hearing that he first began receiving outpatient treatment at the VA Medical Center in Shreveport in 1992, shortly after leaving military service. VA records in the file, however, only date from 1999. Records dated prior to 1999 should be sought as detailed below. 2. Right Knee This issue was previously remanded to allow for the review of previously submitted medical evidence by the Veteran. On remand, the RO reviewed the evidence and provided the Veteran with an updated April 2019 VA examination for the Veteran's right knee. The April 2019 VA examiner indicated that the Veteran's range of motion for the right knee would vary over time depending on the circumstances, but it is not clear if the range of motion that was recorded was the worst that could be anticipated, including during any flare up or after repeated use over time. Clarification should be sought. The matters are REMANDED for the following action: 1. The Veteran should be requested to provide the names, addresses and approximate dates of treatment of all medical care providers, VA and non-VA, who have treated him for the disabilities on appeal since he last provided this information. After the Veteran has signed the appropriate releases, those records should be obtained and associated with the claims folder. 2. The Veteran should be asked to clarify if he received relevant medical care from any Air Force Base hospital after May 2000. Any such medical records should be sought. 3. The RO should attempt to locate and obtain any outstanding VA Medical Center Records dated prior to October 1999, including from the Shreveport VA Medical Center. If no such records exist, that should be indicated. 4. Thereafter, the Veteran's claims file should be returned to the VA examiner who conducted the April 2019 VA knee examination. If that examiner is no longer available, please forward to a person of like skill and qualification. The examiner is to be asked to clarify whether any additional range of motion loss beyond 0 to 125 degrees may occur during flare-ups or after repeated use over time. Any further loss of range of motion considered to occur under these circumstances should be recorded. If it is necessary to examine the Veteran to obtain this information, that should be arranged. If it is not possible to provide the requested information, the reasons for that should be set forth. 5. Thereafter, readjudicate the appeal. M. E. KILCOYNE Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Dodd, Ryan The Board's decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.